MedicaidCoverageMedium impact
All Provider Bulletin 400: Changes in Exclusion of Designated 340B Drugs for MassHealth Coverage
MassHealth·MA · Oncology, Hematology·Pharmacy
Effective date
Aug 18, 2025
We identified it
Jun 18, 2026
Summary
MassHealth will stop paying for 9 specific high-cost drugs (including gene therapies like Amtagvi, Beqvez, Casgevy) when purchased through the 340B Drug Pricing Program starting August 18, 2025. Providers must use non-340B stock to receive MassHealth reimbursement for these medications.
Action Required
By March 19, 2025: Review current inventory and usage of the 9 listed drugs (Amtagvi, Beqvez, Casgevy, Elevidys, Lenmeldy, Lyfgenia, Omisirge, Roctavian, Tecelra). Submit comments to MassHealth if affected including Plan type, NDC, drug name, amount paid, quantity, 340B acquisition cost, and potential loss. Before August 18, 2025: Update procurement processes to purchase these drugs outside of 340B program for MassHealth patients to ensure continued reimbursement.